In the news ...
Psychotropic drug prescriptions: Therapeutic advances or
Many theories could be advanced to explain this phenomenon: physicians' lack of knowledge, the influence of the pharmaceutical industry, patient demands or even a possible "fashion factor" when new drugs are marketed. "While we cannot exclude external factors when explaining the prescription increase, we must also take into account the therapeutic reasoning of physicians, who do not prescribe drugs solely under the influence of external factors," Collin explained.
Regarding the treatment of depression today, Collin notes that about 80% of antidepressants are prescribed by family physicians. According to her, their process of reasoning is similar to how their counterparts approached their patients in the nineteenth century in that they mostly take into account the situation of their patients, their difficulties, and their specificity. "We are faced with a social phenomenon in which people visit a doctor because they do not feel well for all sorts of reasons, but it is not necessarily a question of mental illness. The doctors then have a tool before them that can often work, the antidepressant, which has become a sort of panacea. This is another reason for the prescription increase," says Collins.
"On the one hand, there is constant expansion of diagnostic categories in the
DSM, which aims to standardize diagnostic and therapeutic practices, and on the other hand, we work with patients whose life experiences are complex.
What doctors say is that the DSM does not correspond to real practice. They are caught in the tension between wanting to consider patients as specific individuals, to tailor treatments to them, and the need for standardized practice," explains Collin. "It seems that the desire for psychiatry based on a kind of universalism is removed from the reality of doctors and psychiatrists, who stress the need for a comprehensive approach involving the bio-psycho-social dimensions of the patient," she concludes.
Painkillers, Drug Addiction
Opioid painkiller addiction and accidental overdoses have become far too common across the United States. To try to identify who is most at risk, Mayo Clinic researchers studied how many patients prescribed an opioid painkiller for the first time progressed to long-term prescriptions. The answer: 1 in 4. People with histories of tobacco use and substance abuse were likeliest to use opioid painkillers long-term.
While the study identified past or present nicotine use and substance abuse as top risk factors for long-term use of opioids, all patients should proceed with caution when offered opioid painkiller prescriptions, says lead author W. Michael Hooten, M.D., an anesthesiologist at Mayo Clinic in Rochester.
"From a patient perspective, it is important to recognize the potential risks associated with these medications. I encourage use of alternative methods to manage pain, including non-opioid analgesics or other nonmedication approaches," Dr. Hooten says. "That reduces or even eliminates the risk of these medications transitioning to another problem that was never intended."
Long-term opioid use may actually make people more sensitive to pain - a condition called opioid-induced hyperalgesia, another recently published study by Dr. Hooten and other Mayo researchers found.
If opioids must be used, as is usually the case with surgery or traumatic injuries, reducing the dose and limiting the duration of use is important, Dr. Hooten says.
© All rights reserved
Concise Encyclopedia.com, Research Online, Search Engines, Dictionaries, Reference Desk, Wikipedia encyclopedia, World encyclopedia, Internet encyclopedia, and unlimited Internet Resources ...